Ramadan is the ninth month of the Muslim calendar and the daylight fasting that accompanies it is one of the five pillars of Islam. Fasting during Ramadan is obligatory for all healthy adult Muslims, although exemptions exist for people with serious medical conditions, including many with diabetes.
However, there are certain precautions one should take while they fast.
- Consult your doctor:
- Please consult your doctor and take advice regarding whether it is safe for you to fast.
- You may also need changes in the dose of your drugs or insulin which your doctor will advise according to your present sugar status.
- Due to the present corona pandemic scenario, it is advisable to consult with your doctor if possible, on the telephone or through online consultation.
- Diet during Ramadan
- Try and have the sehri as late as possible in the dawn so that the duration of fast is slightly reduced.
- For sehri, have more complex carbohydrates so that the absorption is delayed over many hours and your sugar levels don’t drop after a few hours. Complex carbs are present in chapati, roti, vegetables, sprouts, lentils, fruits, and milk.
- Drink plenty of water during non fasting hours so that you stay hydrated.
- For Iftar, though you would be hungry from the long hours of fast, try not to overeat. Eat-in moderation and do not have sugary foods like aerated drinks, artificial juices, falooda and sweets. However, you can eat chicken, meat, fish and milk products.
- Dates are rich in sugars and have a high glycemic index. Hence do not have more than 2 to 3 dates during iftar.
- Exercise :
- Exercise for atleast 30 minutes a day for five days a week.
- Due to the present lockdown, it is best to exercise at home itself.
- The late evening and pre- iftar is the time when the risk of hypoglycemia is highest. Hence, shift the time of exercise after iftar.
- However, excessive physical activity may lead to higher risk of hypoglycemia and should be avoided, particularly during the few hours before the sunset meal.
- Checking the blood sugars:
- Please check your blood sugars thrice a week to once in two weeks, frequency depending upon your present sugar levels and as advised by your doctor.
- You may check your sugars prior to sehri, afternoon around 1pm and at pre-iftar time.
- You also need to check your sugars at any time of the day if you develop symptoms of hypoglycemia(low sugar). Symptoms of hypoglycemia are sweating, tremors, palpitations, increased hunger, giddiness and
Pic courtesy: Ramadan and Diabetes: Guide to a safe fast International Diabetes Federation (IDF), in collaboration with the Diabetes and Ramadan (DAR) International Alliance
- Breaking the fast:
- One should always and immediately end their fast if hypoglycemia (blood glucose of <70 mg/dl) occurs because their blood glucose may drop further if they delay treatment.
- Finally, the fast should be broken if blood glucose exceeds 300 mg/dl.
- You should avoid fasting on “sick days.”
- Who should not fast?
People with the following conditions or complications should avoid fasting. However, it is best to consult your doctor before you decide on anything.
- Severe and repeated low blood glucose events three months before Ramadan.
- Kidney problems or on Dialysis
- Type 1 diabetes or type 2 diabetes with multiple daily insulin injections.
- Uncontrolled diabetes
- Pregnant women and children
Lastly, this time Ramadan fasting will be particularly challenging due to the corona pandemic and stringent lockdown in place. Our best wishes and prayers to all our Muslim friends, brothers and sisters for a very happy and safe Ramzaan.
References:
- Recommendations for Management of Diabetes during Ramadan Diabetes Care 2005 Sep;28(9):2305-2311.
- Ramadan and Diabetes: Guide to a safe fast International Diabetes Federation (IDF), in collaboration with the Diabetes and Ramadan (DAR) International Alliance
Author: Dr Vikrant Ghatnatti, DM (Endocrinology), Consultant Endocrinologist, KLES Dr Prabhakar kore Hospital & Ghatnatti Endocrine Centre, Belagavi.
